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Initial Evaluation of the Patient With Lung Cancer*: Symptoms, Signs, Laboratory Tests, and Paraneoplastic Syndromes

Michael A. Beckles, MB, BS; Stephen G. Spiro, MD; Gene L. Colice, MD, FCCP; Robin M. Rudd, MD
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*From the Department of Respiratory Medicine (Dr. Beckles), Royal Free Hospital, London, UK; Department of Respiratory Medicine (Dr. Spiro), Middlesex Hospital, London, UK; Pulmonary, Critical Care and Respiratory Services (Dr. Colice), Washington Hospital Center, Washington, DC; and Department of Medical Oncology (Dr. Rudd), St. Bartholomew’s Hospital, Smithfield, London, UK.

Correspondence to: Stephen G. Spiro, MD, Department of Respiratory Medicine, The Middlesex Hospital, Mortimer St, London W1T 3AA, United Kingdom; e-mail: stephen.spiro@uclh.org



Chest. 2003;123(1_suppl):97S-104S. doi:10.1378/chest.123.1_suppl.97S
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This chapter describes the components of the initial evaluation for a patient either suspected or known to have lung cancer. The components of the initial evaluation are based on the recognized manifestations of localized lung cancer, ie, symptoms referable to the primary tumor, intrathoracic spread of lung cancer, and patterns of metastatic dissemination. Features of the history and physical signs may be useful indicators of the extent of disease. A standardized evaluation, relying on symptoms, signs, and routinely available laboratory tests, can serve as a useful screen for metastatic disease. Also described are the common features of the various paraneoplastic syndromes associated with lung cancer.


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